Introduction
The causes of pain in the forearm can be varied, but in most cases they are due to incorrect or excessive strain on the muscles. Particularly in the case of manual workers or athletes, the pain is usually the result of mechanical stress on the hands or forearms. It is not uncommon for chronic pain to make it difficult or even impossible to pursue one’s profession or sporting goals.
In the center of a successful therapy are the thorough diagnosis and the adherence to the therapy plan, which partly also includes the complete protection of the extremity. Often, stress-related pain in the forearms occurs on the side that is more strained for the individual, i.e. the right side for right-handed people and the left side for left-handed people. In this chapter we will focus on pain in the right forearm. Slightly less frequently than forearm overload, diseases of the shoulder joint, the cervical spine or even the internal organs can cause pain in the right forearm. When making a diagnosis, an illness from the rheumatic form should also be taken into consideration.
Overview of possible diseases
We start with the load-related diseases of the right forearm, which are of course more common in right-handed people than in left-handed people. A widely known disease that causes pain in the forearm is tendovaginitis, which is called tendovaginitis in medical terminology. A tendosynovial sheath is the sheath that surrounds a tendon, gives it lubricity and guarantees wear-free work.
However, the protective system does not work faultlessly under all conditions and is occasionally overstrained when subjected to large and unphysiological loads. Particularly during the prolonged use of computers or tools, but also during the practice of certain sports or the extensive playing of musical instruments, inflammation of the tendon sheaths can occur, resulting in movement-dependent pain in the forearm and local swelling and redness. The cause of tendosynovitis is usually a long-lasting and previously unaccustomed strain, such as when starting a new sport or learning to play a new musical instrument.
In times of intensive use of smartphones, a clinical picture, the so-called SMS thumb, which is an inflammation of the first tendon compartment, occurs particularly frequently. Other stress-related diseases that can be accompanied by pain in the forearm are tennis elbow and golfer’s elbow as well as bursitis olecrani. In these diseases, the pain radiates from the elbow into the forearm.
These clinical pictures will be discussed in more detail later. With advancing age, the probability of suffering from another form of stress-related pain increases, i.e. arthrosis. This is a disease characterized by excessive wear and tear of the joint surfaces, accompanied by the symptoms of joint pain, swelling and joint stiffness.
Wear and tear is promoted by prolonged and intensive stress on a joint, incorrect posture and malpositions, such as those that occur after bone fractures have healed. Inflammatory processes in the context of chronic joint inflammation are called arthritis. An inflammation of the joints, as it occurs in rheumatoid arthritis, a disease from the rheumatic form, can affect almost every joint in the body and cause pain in the forearm.
Rheumatoid arthritis should be considered if other joints besides the joints of the forearm are affected and redness and swelling of the affected areas of the body occur. If pain in the forearm occurs as a result of strong forces, a fracture of one of the two forearm bones ulna and radius or of the wrist should be considered. Since bone fractures are usually accompanied by severe pain and bruising as well as not inconsiderable restrictions of movement, at least the suspicion of a fracture is easy to establish.
It must be followed up promptly by appropriate radiological imaging. The most common fracture in humans is the fracture of the radius near the wrist. It occurs mainly when falling onto the extended hand.The radial head fracture, another common fracture is usually the result of catching a fall with the elbow outstretched.
In this case, the radial head fracture, i.e. the part of the radius near the elbow that is involved in the formation of the elbow joint, breaks. Fractures of the middle part of the forearm are rarer and usually occur in the event of massive violence, for example in a traffic accident. The so-called parry fracture is such a fracture of the middle part of the forearm.
Here, ulna and radius are often involved simultaneously. A paralyzed fracture is a defensive injury and occurs when a person is hit by a baseball bat or the like. Other injuries that can cause pain after applying force to the forearm are strains of the forearm muscles, contusions or sprains of the joints involved (wrist, elbow joint). In rare cases, organ diseases are the cause of pain in the right arm. This point will be explained in more detail below.
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